Atrial fibrillation-related stroke in women : Evidence and inequalities in epidemiology, mechanisms, clinical presentation, and management
| Autor: | Anna Kostopoulou, Šime Manola, Jordi Heijman, Francisco Costa, Reza Wakili, Manav Sohal, Simon Kochhaeuser, Harilaos Bogossian, Ghazala Irfan, Daniel Scherr, Michael Wolf, Radu Ciudin, Hrvojka M Zeljko |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
sex differences
medicine.medical_specialty Medizin menopause Review HEART-DISEASE 030204 cardiovascular system & hematology Sudden death Risk Assessment WARFARIN 03 medical and health sciences 0302 clinical medicine Sex Factors Risk Factors ANTICOAGULATION Epidemiology medicine Humans atrial fibrillation 030212 general & internal medicine Risk factor Intensive care medicine Stroke CATHETER ABLATION GENDER-DIFFERENCES business.industry HORMONE REPLACEMENT THERAPY Anticoagulants Atrial fibrillation General Medicine medicine.disease OPEN-LABEL stroke Menopause ISCHEMIC-STROKE Heart failure RISK-FACTORS Female hemorrhage Cardiology and Cardiovascular Medicine Risk assessment business FOLLOW-UP |
| Zdroj: | Clinical Cardiology |
| Popis: | Background: Atrial fibrillation (AF) is the most common clinical arrhythmia and one of the major causes of stroke, heart failure, sudden death, and cardiovascular morbidity. Despite substantial advances in (interventional) rhythm control treatment during the last decade, anticoagulation for stroke prevention remains a major component of AF treatment. Hypothesis: There are important sex-specific differences in AF-related stroke, resulting from sex-specific mechanisms and therapeutic differences. Methods: This review summarizes available data on sex differences in risk assessment and prevention of stroke and highlights current knowledge gaps in AF-related stroke mechanisms, prevention and management that warrant further research. Results: Increased thrombotic risk in women is multifactorial, involving hormonal changes after menopause, structural, endocrine and lifestyle/social factors and their interactions. It is clear from randomized studies that women benefit from anticoagulant treatment and that their bleeding risk is similar to men. Women should therefore receive equivalent treatment to men, based on the validated criteria for anticoagulation therapy. However, women are not represented equally in the large randomized studies and sex-related information in many fields is lacking. Conclusions: Female sex is an established risk factor for stroke in AF patients. The evidence for sex-specific differences in stroke risk assessment and stroke prevention is accumulating. However, the underlying biological mechanisms remain incompletely understood and further studies are required in order to decrease AF-related morbidity and mortality. CA extern |
| Databáze: | OpenAIRE |
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